Risk for COVID-19 infection and death among Latinos in the United States: examining heterogeneity in transmission dynamics

Abstract

Purpose: The purpose of this study was to ascertain COVID-19 transmission dynamics among Latino communities nationally.

Methods: We compared predictors of COVID-19 cases and deaths between disproportionally Latino counties (≥17.8% Latino population) and all other counties through May 11, 2020. Adjusted rate ratios (aRRs) were estimated using COVID-19 cases and deaths via zero-inflated binomial regression models.

Results: COVID-19 diagnoses rates were greater in Latino counties nationally (90.9 vs. 82.0 per 100,000). In multivariable analysis, COVID-19 cases were greater in Northeastern and Midwestern Latino counties (aRR: 1.42, 95% CI: 1.11-1.84, and aRR: 1.70, 95% CI: 1.57-1.85, respectively). COVID-19 deaths were greater in Midwestern Latino counties (aRR: 1.17, 95% CI: 1.04-1.34). COVID-19 diagnoses were associated with counties with greater monolingual Spanish speakers, employment rates, heart disease deaths, less social distancing, and days since the first reported case. COVID-19 deaths were associated with household occupancy density, air pollution, employment, days since the first reported case, and age (fewer <35 yo).

Conclusions: COVID-19 risks and deaths among Latino populations differ by region. Structural factors place Latino populations and particularly monolingual Spanish speakers at elevated risk for COVID-19 acquisition.

Keywords: COVID-19; Disparity; Hispanic; Latino; Race.

Fig. 1

Rates of COVID-19 diagnosis in disproportionally Latino (≥17.8% of population) and all other counties (<17.8% of population) as of May 11, 2020. Puerto Rico was included as a single data point.

Fig. 2

Rates of COVID-19 deaths in disproportionally Latino (≥17.8% of population) and all other counties (<17.8% of population) as of May 11, 2020. Puerto Rico was included as a single data point.

Fig. 3

COVID-19 cases per 100,000 population (adjusted per day since detection) by proportion of Latino residents in the Northeast, Midwest, West, and South of the United States as of May 11, 2020.

Fig. 1

Rates of COVID-19 diagnosis in disproportionally Latino (≥17.8% of population) and all other counties (<17.8% of population) in New York, New Jersey, and Connecticut as of May 11, 2020. As of May 11, 38.2% (509,763/1,334,088) of all COVID-19 cases were in New York, New Jersey, or Connecticut.

Fig. 2

Rates of COVID-19 deaths in disproportionally Latino (≥17.8% of population) and all other counties (<17.8% of population) in New York, New Jersey, and Connecticut as of May 11, 2020. As of May 11, 49.1% (39,038/79,448) of all COVID-19 deaths were in New York, New Jersey, or Connecticut.